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NPI Code Detail

MEDICARE: NOEUD DE PAPILLON LTD

MEDICARE: NOEUD DE PAPILLON LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine PhysicianMD00019338WA
22084A0401XAddiction Medicine (Psychiatry & Neurology) PhysicianMD00019338WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568692705
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOEUD DE PAPILLON LTD
Provider Business Mailing Address
First Line : 1334 LAWRENCE ST
Second Line :
City : PORT TOWNSEND
State : WA
Zip : 98368-6529
Country : US
Telephone Number : 360-385-4843
Fax Number :
Provider Business Practice Location Address
First Line : 1334 LAWRENCE ST
Second Line :
City : PORT TOWNSEND
State : WA
Zip : 98368-6529
Country : US
Telephone Number : 360-385-4843
Fax Number :
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : DR. JAMES KIMBER ROTCHFORD
Credential : MD,MPH, FAAMA
Telephone Number : 360-385-4843
Provider Enumeration Date : 07/22/2009
Last Update Date : 08/20/2009

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Directions to “NOEUD DE PAPILLON LTD ” Practice Location

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